2020 年第 9 期 第 15 卷

镍钛记忆合金治疗创伤性连枷胸的临床效果及对骨形态发生蛋白和炎性因子水平的影响

Clinical effect of nickel-titanium memory alloy on traumatic flail chest and its effect on bone morphogenetic protein and inflammatory factors

作者：张帆1张潍1孙党泽1辛伟2周勇锋2

英文作者：Zhang Fan1 Zhang Wei1 Sun Dangze1 Xin Wei2 Zhou Yongfeng2

单位：1西安交通大学第二附属医院胸外科（张帆现就职于陕西省宝鸡市中医医院胸外科）721004；2陕西省宝鸡市中医医院胸外科721001

英文单位：1Department of Chest Surgery Second Affiliated Hospital of Xi′an Jiaotong University Xi′an 721004 China(Zhang Fan now works in the Department of Chest Surgery Baoji Hospital of Traditional Chinese Medicine Shaanxi Province); 2Department of Chest Surgery Baoji Hospital of Traditional Chinese Medicine Shaanxi Province Baoji 721001 China 

关键词：创伤性连枷胸；镍钛记忆合金；骨形态发生蛋白；炎性因子；并发症

英文关键词：Traumaticflailchest;Nickel-titaniummemoryalloy;Bonemorphogeneticprotein;Inflammatoryfactors;Complication 

• 摘要：

• 目的 观察镍钛记忆合金治疗创伤性连枷胸的临床效果及对骨形态发生蛋白（BMP）和炎性因子水平的影响。方法 选取2016年8月至2018年8月西安交通大学第二附属医院诊治的创伤性连枷胸患者120例为研究对象。完全随机分为对照组和观察组，各60例。对照组患者采用常规的非手术治疗，胸壁用多头肋骨带及厚棉垫加压固定；观察组患者进行镍钛记忆合金环抱器内固定术治疗。观察2组患者的临床治疗效果及治疗前后BMP和炎性因子水平的变化，比较并发症发生情况。结果观察组机械通气时间、胸腔引流管拔管时间及住院时间均明显短于对照组，差异均有统计学意义（均P<0.05）。治疗后，2组血清中BMP-2、BMP-7及BMP-14水平均较治疗前明显升高，且观察组高于对照组［（8.7±1.6）μg/L比（4.9±1.1）μg/L、（9.7±2.0）μg/L比（6.2±1.9）μg/L、（9.5±1.3）μg/L比（5.6±1.1）μg/L］；2组白细胞介素2（IL-2）、IL-10及C反应蛋白水平均较治疗前明显降低，且观察组低于对照组［（39±5）ng/L比（45±4）ng/L、（35±9）ng/L比（40±6）ng/L、（12.1±2.8）mg/L比（18.4±5.4）mg/L］，差异均有统计学意义（均P<0.05）。观察组并发症发生率明显低于对照组［23.3%（14/60）比63.3%（38/60）］，差异有统计学意义（P<0.05）。结论 镍钛记忆合金能有效治疗创伤性连枷胸，且安全性高，同时对异常的BMP及炎性因子有明显的恢复作用。

• Objective To observe the clinical effect of nickel-titanium memory alloy on traumatic flail chest, bone morphogenetic protein(BMP) and inflammatory factors levels. Methods From August 2016 to August 2018， 120 patients with traumatic flail chest admitted to the Second Affiliated Hospital of Xi′an Jiaotong University were selected.They were randomly divided into control group（60 cases） and observation group（60 cases）. The patients in control group were treated with routine non-surgical treatment, compression fixation of chest wall with multi rib band and thick cotton pad. The patients in observation group were treated with nickel-titanium memory alloy embracing fixator. The clinical effect of treatment, changes of BMP and inflammatory factors levels before and after treatment were analyzed. The complications were compared between two groups. Results The mechanical ventilation time, extubation time of thoracic catheter and hospitalization time in observation group were significantly shorter than those in contro group(all P<0.05). Serum levels of BMP-2, BMP-7 and BMP-14 in both groups were significantly higher than those before treatment， which in observation group were higher than those in control group［（8.7±1.6）μg/L vs （4.9±1.1）μg/L, （9.7±2.0）μg/L vs （6.2±1.9）μg/L, （9.5±1.3）μg/L vs （5.6±1.1）μg/L］(all P<0.05). The levels of interleukin-2 (IL-2), IL-10 and C-reactive protein in both groups were significantly lower than those before treatment; the levels in observation group were lower than those in control group［（39±5）ng/L vs （45±4）ng/L, （35±9）ng/L vs （40±6）ng/L, （12.1±2.8）mg/L vs （18.4±5.4）mg/L］(all P<0.05). The incidence of complications in observation group was significantly lower than that in control group ［23.3%(14/60) vs 63.3%(38/60)］(P<0.05). Conclusion Nickel-titanium memory alloy caneffectively treat traumatic flail chest, improve bone morphogenetic protein and inflammatory factors.